Impact of intrauterine infusion of human chorionic gonadotropin and hyaluronic acid enriched medium on pregnancy outcomes in frozen-thawed cycles with recurrent implantation failure: An RCT.

IF 1.4 Q3 OBSTETRICS & GYNECOLOGY
International Journal of Reproductive Biomedicine Pub Date : 2025-11-01 eCollection Date: 2025-09-01 DOI:10.18502/ijrm.v23i9.20158
Sepideh Peivandi, Pegah Jafarifard, Marzieh Zamaniyan, Jamshid Yazdani-Charati
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Abstract

Background: Recurrent implantation failure in assisted reproductive technology is a major challenge. Intrauterine human chorionic gonadotropin (hCG) infusion and hyaluronic acid enriched embryo transfer media have shown individual effects, but their combined effect in these cases undergoing frozen-thawed embryo transfer is unknown.

Objective: This study aims to investigate the effect of combined therapy on pregnancy outcomes.

Materials and methods: This is a single-blind, randomized controlled trial on 158 participants. The cases were randomly assigned to either the intervention group (pretransfer intrauterine hCG infusion and embryo loaded with hyaluronic acid-enriched embryo transfer medium at the time of transfer) or the control group (standard embryo transfer medium). The outcomes were chemical and clinical pregnancy rates, implantation, abortion, and ongoing pregnancy rates.

Results: A total of 158 participants were enrolled in this study in 2 equal groups. The intervention did not significantly improve the overall pregnancy rate compared to control (24% vs. 33.7%, p = 0.30). The results showed that, by controlling variables, the chance of clinical pregnancy in the intervention group was 12% lower than in the control group, although the difference was not statistically significant (p = 0.879). With each increase in the number of embryos, the chance of a pregnancy would be 2.26 times higher. Also, the chance of pregnancy in the morula stage was 68% lower than in the cleavage stage (p < 0.05).

Conclusion: The combined approach of intrauterine hCG infusion and the hyaluronan-enriched embryo transfer medium did not significantly improve the overall pregnancy rate but had a significant effect on specific cases using the embryo at the cleavage stage for transfer and cases that received more than one embryo for transfer.

Abstract Image

宫内输注人绒毛膜促性腺激素和透明质酸富集培养基对反复植入失败的冻融周期妊娠结局的影响:一项随机对照试验。
背景:反复着床失败是辅助生殖技术面临的主要挑战。宫内灌注人绒毛膜促性腺激素(hCG)和富含透明质酸的胚胎移植培养基已显示出单独的效果,但它们在这些进行冷冻解冻胚胎移植的病例中的联合效果尚不清楚。目的:探讨综合治疗对妊娠结局的影响。材料和方法:这是一项单盲、随机对照试验,共有158名参与者。这些病例被随机分配到干预组(移植前宫内hCG输注和胚胎在移植时加载富含透明质酸的胚胎移植培养基)或对照组(标准胚胎移植培养基)。结果是化学和临床妊娠率、着床率、流产率和持续妊娠率。结果:158名受试者被纳入本研究,分为两组。与对照组相比,干预没有显著提高总妊娠率(24%对33.7%,p = 0.30)。结果显示,通过控制变量,干预组临床妊娠的几率比对照组低12%,但差异无统计学意义(p = 0.879)。随着胚胎数量的增加,怀孕的几率将增加2.26倍。桑葚期的妊娠率比乳沟期低68% (p < 0.05)。结论:宫内灌注hCG与富透明质酸的胚胎移植液联合使用对整体妊娠率没有显著提高,但对使用卵裂期胚胎进行移植和接受多个胚胎进行移植的特定病例有显著影响。
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来源期刊
CiteScore
2.40
自引率
7.70%
发文量
93
审稿时长
16 weeks
期刊介绍: The International Journal of Reproductive BioMedicine (IJRM), formerly published as "Iranian Journal of Reproductive Medicine (ISSN: 1680-6433)", is an international monthly scientific journal for who treat and investigate problems of infertility and human reproductive disorders. This journal accepts Original Papers, Review Articles, Short Communications, Case Reports, Photo Clinics, and Letters to the Editor in the fields of fertility and infertility, ethical and social issues of assisted reproductive technologies, cellular and molecular biology of reproduction including the development of gametes and early embryos, assisted reproductive technologies in model system and in a clinical environment, reproductive endocrinology, andrology, epidemiology, pathology, genetics, oncology, surgery, psychology, and physiology. Emerging topics including cloning and stem cells are encouraged.
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